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CITY-OF ORONO PERMIT <br /> 2750 Kelley Parkway - PO Box 66 Permit Number: Po4114 <br /> Crystal Bay, Minnesota 55323 Permit Type: NeW stru�ture <br /> (952) 249-4600 Date Issued: si9i2oot <br /> SITE ADDRESS: 2345 Blaine Avenue(Well No. 3 Pumphous <br /> Wayzata,lV�1 55391 <br /> PID: t7-117-23-34-0011 <br /> DESCRIPTION: UBC Occupancy R3 <br /> Construction Type VN <br /> Proposed Use: Other <br /> Permit Class: Building Census Code 328 <br /> Permit Type: New Structure Permit Sub-type(s): Building Undefined <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: Giec�ricai�sratej <br /> NOTICES/REMARKS: <br /> TI___ '_ _ '____. ____.'_'___._�..__.__ ___.1 _"_i_. ___ .1__ . [1 <br /> ....D .�.1..G.. O:i:.:t::,,::............:....a..�c....:.:..... ....G ...7..G. �....G.-.. <br /> .... . .. "' ' " "' """" '... ... ..:. .... ... ... . . ...:.: : ... <br /> FEE SUMMARY: Permit Fee: $ 783•�5 Valuation: $ 70,000.00 <br /> Plan Review Fee: $ 509.53 <br /> State Surcharge Fee: $ 35.00 <br /> TOTAL FEE: $ 1,328.28 <br /> APPLICANT: Design One OWNER: Village of Orono(Well No. 3 Pumphouse) <br /> 9973 Valley View Rd P.O.Box 66 <br /> Eden Praire, MN 55344 Crystal Bay,MN 55323 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPL[ANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> ' ��/ <br /> � ��. � �� i r���?'i�`�� r��� ;'���� <br /> APPLICANT PERMITEE SIG TURE ISSUEDBY IGNATURE <br /> Copies: 1-File(SiQnitures Reauired), 1-Applicant. 1-Monthlv Reports, 1-Assessin�. 1-Finance Page 1 <br />